AFTER-HOURS MANAGEMENT OF BLOOD/BODY FLUID EXPOSURE INVOLVING UNIVERSITY EMPLOYEE

GENERAL MEDICINE PHYSICIAN ON CALL,
As you know, when a blood/body fluid exposure has occurred, a decision must be made as quickly as possible on whether to begin HIV Postexposure Prophylaxis (PEP). The information and instructions found here will help you reach that decision and manage the exposure.

If you are the on-call MD contacted about an exposure:

STEP ONE: Decide whether to begin HIV PEP

• 1) For a step-by-step description of "who does what" after an exposure, for example, the role of the House Nursing Supervisor in obtaining HIV testing on the source of the exposure:
  HIV Postexposure Prophylaxis Protocol, Night, Weekends, Holidays
  
• 2) Determine whether an exposure warrants prophylaxis; for example, when is an exposure considered "high risk"?
  Tables 1 & 2 from Management of Bloodborne Exposure (HIV)
  
  
  • If you decide not to begin HIV PEP, counsel the worker to follow-up in the University Employee Occupational Health Clinic (open Monday- Friday, 8:30 – 4:30, 966-9119, 1st floor ACC)
  • If you decide to begin HIV PEP, proceed to Step 2

• 1) For information on medications:
  PEP Prescription Instructions
• 2) Meet the employee in the UNC ED. Packets located in the ED contain resources allowing you to order labwork, prescribe medications, and counsel the exposed worker.

BACKGROUND INFORMATION: Refer to the following information as needed:

• 1) Management of Bloodborne Exposure (HIV)
  
  
• 2) Management of Hepatitis B Virus Prophylaxis, Exposures and Infections
  
  
• 3) Management of Hepatitis C Virus Prophylaxis, Exposures and Infections